Hi Everyone - well we had a productive trip at the Mayo Clinic in Jacksonville this past week. He met with the GI doctor and had fasting labs done on Monday. Tuesday an MRI. Wednesday a sigmoidoscopy examining 2/3rds of the colon. Thursday a free day. Friday met with a colorectal surgeon.
Long story short.....the UC is showing definite signs of heading towards a remission as we thought. The colon is mending and what remains is some mild inflammation on the left side and more stubborn inflammation on the rectal end of things. No surgery is needed which we though might be the case due to the low rectal discomfort.
The pain/discomfort he has before, during and after his bm's concerned the dr which is the reason for the MRI and exam by the colorectal surgeon. The surgeon was not overly concerned - it seems the hemmoroids are quite inflamed from all of this.
The Imuran was increased from 75mg to 150mg which I thought was going to happen after my education on the forum here even though his local GI was being super conservative with the dose. Monthly blood tests for 3 specific things are to be done and the dr will prescribe the imuran on a month to month basis and monitor this new dosage very carefully.
Stopping the colocourt and going to the cortifoam at bed and early am for 4 weeks then just at night and the canasa suppository in the morning.
Iron levels are fine - stop the B12 shots and one iron pill a day instead of 3.
The prednisone tapering will reduce from the current 15mg we are holding at when we get back from ARuba.
Warm sitz baths will help to calm and soothe and relax the rectum. The surgeon also recommended plain zinc oxide around the rectal area -put a little about 1/2" inside and a little on the outside.
He needed to do 2 enemas for the MRI, 2 enemas and the citrus magnesium drink for the sigmoid, and 2 enemas for the colorectal exam. If this had been 6 weeks or so ago he could have never gotten through these 3 preps without some kind of regressing.
He made out so well and bounced back from this so well I was really amazed. I fugured this week's ordeal would set him back and didn't.
It's funny when the Dr mentioned switching to a foam I asked if that would be Cortifoam and when he mentioned a suppository I also asked if it would be canasa. He was a bit surprised that I knew what he might be prescribing. Of course I mentioned I have been getting quite an education from all of you!!!
A good amount of time was spent with us and I think it was an easier treatment since he had already gone through the worst of it and had tried several things and the imuran for the past 4 1/2 months seems to have started to make a difference. So hopefully the doubling up on the imuran will move things along even faster and he will have no problem tolerating that level of a dose.
We go back on November 7th for a follow up and more labs.
I felt so much more prepared for this visit with all the insight I have gotten from here.
60 yr old male~Colitis 1st diagnosed Jan '05-cleared up within a few wks. Flared again in May '06 ... left sided UC now, fully involved and trying to get in remission. Acute inflammation-pancolitis-tenesmus rectal pain-granulation is showing some healing started. Osteopena of spine from prednisone DX 8/07 July 07 good days & bad days 75mg Imuran 40 mg prednisone (tapering 8/07) 12 Asacol, Lidocaine Hydrochloride Jelly 2%,multi vitamin, iron 3X day, DanActive, chewable calcium, Prilosec 20mg, enalapril 10mg, glipizide 5 mg, zocor 20 mg, baby aspirin, (Fentanyl pain patch 50mg 72 hrs Morphine Sulf 15 mg twice daily)Colocourt enemas at night. Fosamax and mthly B12 shots folic acid 1mg